Two significant inquiries into mental health are currently underway: a Productivity Commission Inquiry that is considering the role of mental health in supporting economic participation, enhancing productivity and economic growth; and the Victorian Royal Commission into Mental Health.
Submissions to both inquiries will be forthcoming from the AMA. In 2018, the AMA released its Position Statement on Mental Health (https://ama.com.au/position-statement/mental-health-2018) and the NDIS (https://ama.com.au/position-statement/national-disability-insurance-scheme-2018) .
The former stressed that current appropriations and allocation of funding for mental health services, treatments and workforce needs to be overhauled and realigned. The AMA has said that funding has not been properly weighted between community-based mental health services, acute care and advocacy requirements.
The AMA wants to see all tiers of Government work cooperatively to change the current patchwork of fragmented, competing and overlapping services to one based on evidence, research, investment, and sustainable funding. The AMA position statement called for a multipronged strategy to improve access and care to Australians with mental health needs. This strategy should encompass:
- improved service delivery;
- significantly increased funding;
- improved coordination;
- robust workforce and infrastructure solutions;
- prevention, education and research; and
- e-health/ telemedicine solutions.
We welcome these new inquiries, but governments have a poor record of implementing recommendations and findings. In June 2008, the National Advisory Council on Mental Health (NACMH) was established by then Prime Minister Kevin Rudd. Its report, A Mentally Healthy Future For All Australians (2009) provided expert advice on mental health reform. NACHM detailed 21 priority areas for investment, including: mental health literacy; training; priority communities; community mental health programs; mental health in the workplace; early childhood, youth development and school services; families at high risk; mental health services for the elderly; and expanding community-based support and recovery models. Many of the NACHM recommendations have never been fully implemented or funded.
In 2008, the Senate Standing Committee on Community Affairs released Towards Recovery, Mental Health Services in Australia. This quality and comprehensive report produced 26 recommendations that would deliver a clear vision for mental health systems in Australia. Again, almost none of the recommendations have been implemented. The specific recommendations regarding funding of services and accountability have either been ignored or only partially acted on in the decade since the Senate undertook this inquiry.
In June 2009, the National Health and Hospitals Reform Commission (NHHRC), also established under the Rudd Government, developed a long-term reform plan for Australia. Titled A Healthier Future For All Australians, NHHRC listed a number of recommendations to ensure treatment and support services across the spectrum of care. It made 12 specific recommendations on mental health reform, of which perhaps only two or three have been partially implemented. Recommendations about housing, increasing social support services, vocational rehabilitation, have not be implemented in full.
In June 2010, the Senate Community Affairs References Committee released The Hidden Toll: Suicide in Australia. This report highlighted the enormous personal, social and financial cost of suicide and made 42 very important recommendations to reduce suicide in Australia. Some of the recommendations on data collection and collation, more standardised reporting, and awareness raising, have been acted on, however many of the 42 recommendations remain either partially delivered, or are ad-hoc and inconsistent.
Other reports have been issued by the Australian Mental Health Commission and the Fifth National Mental Health and Suicide Prevention Plan.
We can only hope that the recommendations of the Productivity Commission and Victorian Royal Commission are implemented, and that Commonwealth and State governments collaborate on funded, coordinated strategies that reform and improve mental health services in Australia.